title: Double-crush nerve compression in thoracic-outlet syndrome.
abstract: We studied 165 cases of thoracic-outlet syndrome in 142 patients in whom resection of the first rib had been performed. In seventy-three cases (44 per cent), there was compression of a nerve distally, as shown by electromyography and conduction studies. The most common secondary compression was carpal tunnel syndrome (forty-one cases). Thirteen patients needed an operation at three sites or more. Our results show that proximal compression of a nerve lessens its ability to withstand more distal compression. Once the diagnosis of thoracic-outlet syndrome has been made, the possibility of an additional distal compression neuropathy should be investigated.
authors.affiliation: Department of Orthopaedic Surgery, Loma Linda University Medical Center, California 92350.
authors.forename: V E
authors.initials: VE
authors.lastname: Wood
authors.forename: J
authors.initials: J
authors.lastname: Biondi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000150:complications* / Q000175:diagnosis; D012272:Ribs / Q000601:surgery; D013901:Thoracic Outlet Syndrome / Q000150:complications* / Q000601:surgery